微创经皮肾镜超声与X线定位方式的临床对比

Comparison of ultrasound and X-ray in establishing percutaneous access for minimal invasive percutaneous nephrolithotomy

目的比较微创经皮肾镜碎石取石术中X线与B超引导建立经皮肾通道的效果。方法对132例肾结石的患者,分别随机采用X线C臂机及B超引导建立经皮肾通道一期碎石取石治疗,其中采用X线引导组58例,B超引导组74例。结果 X线引导组和B超引导组建立通道时间分别为(30.2±14.6)min和(10.6±6.2)min,手术前后血红蛋白下降值分别为(18±9)g/L和(11±5)g/L,结石残留率分别为36.2%(21/58)和44.6%(33/74),发生出血等并发症分别为8例和3例;均无死亡患者。结论虽然两种方法各有优缺点,但B超引导下经皮肾镜手术穿刺简单、成功率高、损伤小、并发症少、出血少,多通道建立简便、设备要求低,是今后经皮肾镜发展的方向。

Objective To compare the efficacy of establishing percutaneous access under the guidance of ultrasound and X-ray for minimal invasive percutaneous nephrolithotomy （mPCN）. Methods 58 and 74 cases of renal calculi underwent ini- tial mPCN under the guidance of X-ray and ultrasound respectively. Results In the X-ray group and the ultrasound group, the operation time was （30.2±14.6） and （10.6±6.2）min, Hb was reduced to （18±9）g/L and （11±5） g/L after the opera- tion, the rate of residual stone was 36. 2% （21/58） and 44.6% （33/74）, and 8 and 3 cases respectively developed complica- tions. Conclusion Both techniques have advantages and disadvantages. Ultrasound can easily and effectively establish the percutaneous tract and it will be widely used in mPCN